Weeks Research Articles

COVID-19 vaccine effectiveness against symptomatic infection and hospitalisation in Belgium, July 2021 to May 2022.

BackgroundThe Belgian COVID-19 vaccination campaign aimed to reduce disease spread and severity.AimWe estimated SARS-CoV-2 variant-specific vaccine effectiveness against symptomatic infection (VEi) and hospitalisation (VEh), given time since vaccination and prior infection.MethodsNationwide healthcare records from July 2021 to May 2022 on testing and vaccination were combined with a clinical hospital survey. We used a test-negative design and proportional hazard regression to estimate VEi and VEh, controlling for prior infection, time since vaccination, age, sex, residence and calendar week of sampling.ResultsWe included 1,932,546 symptomatic individuals, of whom 734,115 tested positive. VEi against Delta waned from an initial estimate of 80% (95% confidence interval (CI): 80-81) to 55% (95% CI: 54-55) 100-150 days after the primary vaccination course. Booster vaccination increased initial VEi to 85% (95% CI: 84-85). Against Omicron, an initial VEi of 33% (95% CI: 30-36) waned to 17% (95% CI: 15-18), while booster vaccination increased VEi to 50% (95% CI: 49-50), which waned to 20% (95% CI: 19-21) 100-150 days after vaccination. Initial VEh for booster vaccination decreased from 96% (95% CI: 95-96) against Delta to 87% (95% CI: 86-89) against Omicron. VEh against Omicron waned to 73% (95% CI: 71-75) 100-150 days after booster vaccination. While recent prior infections conferred higher protection, infections occurring before 2021 remained associated with significant risk reduction against symptomatic infection. Vaccination and prior infection outperformed vaccination or prior infection only.ConclusionWe report waning and a significant decrease in VEi and VEh from Delta to Omicron-dominant periods. Booster vaccination and prior infection attenuated these effects.

Effectiveness of Up-to-Date COVID-19 Vaccination in Preventing SARS-CoV-2 Infection Among Nursing Home Residents - United States, November 20, 2022-January 8, 2023.

Nursing home residents have been disproportionately affected by the COVID-19 pandemic; their age, comorbidities, and exposure to a congregate setting has placed them at high risk for both infection and severe COVID-19-associated outcomes, including death (1). Receipt of a primary COVID-19 mRNA vaccination series (2) and monovalent booster doses (3) have been demonstrated to be effective in reducing COVID-19-related morbidity and mortality in this population. Beginning in October 2022, the National Healthcare Safety Network (NHSN) defined up-to-date vaccination as receipt of a bivalent COVID-19 mRNA vaccine dose or completion of a primary series within the preceding 2 months.* The effectiveness of being up to date with COVID-19 vaccination among nursing home residents in preventing SARS-CoV-2 infection is not known. This analysis used NHSN nursing home COVID-19 data reported during November 20, 2022-January 8, 2023, to describe effectiveness of up-to-date vaccination status (versus not being up to date) against laboratory-confirmed SARS-CoV-2 infection among nursing home residents. Adjusting for calendar week, county-level COVID-19 incidence, county-level social vulnerability index (SVI), and facility-level percentage of staff members who were up to date, up-to-date vaccine effectiveness (VE) against infection was 31.2% (95% CI=29.1%-33.2%). Nursing home residents should stay up to date with recommended age-appropriate COVID-19 vaccination, which now includes an additional bivalent vaccine dose for moderately or severely immunocompromised adults aged ≥65 years to increase protection against SARS-CoV-2 infection.

COVID-19 and Artisan Labourers in Urban Owerri, Imo State, Nigeria: A Study on Resilience

This article examines the sociology of work in an unstable environment produced by COVID-19 with emphasis on sustenance of employment among urban artisan labourers in Owerri, Imo State. It interrogates the resilience of this occupational type in the face of such disruptive shock as COVID-19. it aims to understand the ways in which COVID-19 Pandemic has affected the ability of artisan labourers to secure employment and value for their labour. A sample of 180 respondents was randomly selected from six different artisan labour market locations for the study. Survey method was used since there is a need for data from the artisan workers themselves. The nonparametric methods of analysis namely; Spearman’s rank correlation was adopted to analyze collected data. Results show significant erosion of employment potentials with 50 percent reduction in number that had a 7-day work week, reduced work time, unaffected earning potentials, engagement with higher number of short-term contracts per capita, 50% reduction in number that never did short term work, conscription of greater number of household members and eroded buying power of compensation packages and sundry rewards for work. This shows that though Nigeria was not one of the most affected countries, it has, however experienced reverberations from the most affected countries. The results compel the advocacy that persons in the informal sector may have to benefit from government programmes for the formal sector such as pension schemes.

Weight Gain and Metabolic Changes in Patients With First-Episode Psychosis or Early-Phase Schizophrenia Treated With Olanzapine: A Meta-Analysis.

Patients with first-episode psychosis or early-phase schizophrenia are susceptible to olanzapine-associated weight gain and cardiometabolic dysregulation. This meta-analysis characterized weight and metabolic effects observed during olanzapine treatment in randomized clinical trials in this vulnerable patient population. PubMed, EMBASE, and Dialog were searched for randomized controlled trials (RCTs) reporting weight or cardiometabolic outcomes associated with olanzapine treatment in first-episode psychosis or early-phase schizophrenia. Random-effects meta-analysis and meta-regression were conducted using R v4.0.5. Of 1203 records identified, 26 RCTs informed the analyses. The meta-analytic mean (95% CI) weight gain was 7.53 (6.42-8.63) kg in studies (n = 19) that reported weight gain with olanzapine treatment. Stratified by duration, the mean (95% CI) weight gain was significantly higher in studies >13 weeks in duration than in those lasting ≤13 weeks: 11.35 (10.05-12.65) vs 5.51 (4.73-6.28) kg, respectively. Despite between-study variability, increases from baseline in most glycemic and lipid parameters were generally small in studies of both ≤13 and >13 weeks. There were no correlations, however, between weight gain and metabolic parameter changes when stratified by study duration. In RCTs enrolling patients with first-episode psychosis or early-phase schizophrenia, olanzapine was consistently associated with weight gain that was greater in studies lasting >13 weeks compared with those of ≤13 weeks. Metabolic changes observed across studies suggest that RCTs may underestimate metabolic sequelae vs real-world treatment observations. Patients with first-episode psychosis or early-phase schizophrenia are vulnerable to olanzapine-associated weight gain; strategies minimizing olanzapine-associated weight gain should be carefully considered.

COUNTERPOINT: the Seductive Trap of Relying on Exaggerated Effects in Short-Term Heart Failure Trials to Predict Benefits and Risks in Patients With Long-Term Disease

COUNTERPOINT: the Seductive Trap of Relying on Exaggerated Effects in Short-Term Heart Failure Trials to Predict Benefits and Risks in Patients With Long-Term Disease

P26 Epidemiology and risk factors associated with and clinical approach to Staphylococcus aureus bacteraemia at North West Anglia Foundation Trust (NWAFT)

Abstract Background Staphylococcus aureus bacteraemia (SAB) is associated with high mortality and morbidity. Certain patient groups are predisposed to developing SAB. Careful monitoring of these patients for persistence of bacteraemia and development of complications is important to improve prognosis. There is international consensus on (i) treating patients with at least 2 weeks of IV antibiotics, (ii) performing echocardiography to evaluate for infective endocarditis and (iii) repeating blood cultures 2–4 days after initiating empirical treatment. Adherence to trust antimicrobial guidelines is also imperative to national antimicrobial stewardship. Objectives To characterize patients at risk of SAB and make recommendations to reduce the incidence and complications of SAB. Methods Retrospective review of case notes of patients whose blood culture results were positive for S. aureus from April to September 2022 in NWAFT. 57 results from 51 patients aged 0 to 96 years were included. The four audit standards were compliance with (i) trust empirical antimicrobial guidelines, (ii) 2-week duration of IV therapy, (iii) echocardiography evaluation for endocarditis, and (iv) repeat blood cultures 48–96 hours after initiating empirical treatment. Patients who were on palliative pathway were excluded from analysis of standards two to four. Prognostic outcomes were examined in terms of hospital readmission, recurrence and mortality. Results 36 patients (70.6%) were found to harbour known risk factors, with the presence of indwelling prosthetic devices (83.3%) and type 2 diabetes (25.0%) being the most common. The most frequent sources of infection were unknown (27.5%) as well as the skin or soft tissue (17.6%). MRSA bacteraemia accounted for 10.5% of all cases. The compliances with (i) trust empirical antimicrobial guidelines, (ii) 2-week duration of IV therapy, (iii) echocardiography evaluation of endocarditis and (iv) repeat blood cultures 48–96 hours after initial blood culture were 52.8%, 75.0%, 57.8% and 66.0%, respectively. Rates of hospital readmission, recurrence and mortality were 39.5%, 11.4% and 35.3%, respectively. Conclusions The incidence of SAB correlates with the presence of risk factors, and SAB is associated with adverse outcomes. There was partial compliance with the audited outcomes. Introduction of trust SAB guidelines to guide clinical approach and adherence to local antimicrobial prescribing guidelines are imperative to improving patient outcomes.

A randomized, placebo-controlled trial evaluating the safety of excessive administration of kaempferol aglycone.

Kaempferol (KMP) is an important flavonoid in many fruits and vegetables. Preclinical studies on KMP have reported its pharmacological effects, including antimicrobial, antioxidant, anti-inflammatory, antitumor, antidiabetic, myocardial protective, and neuroprotective effects. Additionally, some epidemiological studies have revealed a negative association between the consumption of KMP-containing foods and the risk of developing several disorders, such as cancer and cardiovascular diseases. Thus, although a large body of literature has demonstrated the benefits of KMP supplementation, there are no reports of clinical trials evaluating the safety of KMP aglycone administration or KMP aglycone-rich food consumption. The purpose of this study was to evaluate the safety of a high dose of KMP aglycone by administrating KMP aglycone-containing supplements to healthy adults. This study had a randomized, double-blind, placebo-controlled design and a 4-week duration. Participants were randomly allocated to the KMP (n = 24) or placebo (n = 24) group. For 4 weeks, the KMP group received a capsule containing 50-mg KMP daily, a dose approximately five times higher than the estimated human dietary intake. The placebo group received a capsule containing cornstarch-based powder daily. The general toxicity parameters were evaluated by examining the characteristics of the participants, hematological and blood biochemical parameters, general urinalysis, qualitative urine tests, and adverse events. No clinical changes were observed in anthropometric and blood pressure measurements or blood and urine parameters in the KMP group compared to those in the placebo group. Furthermore, no adverse events owing to KMP aglycone administration occurred. The study results revealed that the consumption of 50-mg KMP aglycone daily for 4 weeks is safe in healthy adults.

Tension band wiring of fracture distal end of clavicle: Favorable clinical outcome among the patients

Background: A fracture of the clavicle is common traumatic injury. It can be classified into middle third, medial third, and distal third fractures. Around 10–15% of clavicle fractures occur in the distal third. The ideal method of fixation in distal third clavicle fracture remains controversial till date. Aims and Objectives: The clinical outcome of the patients having fracture of the distal end clavicle using rigid fixation with tension band wiring (TBW) with Kirshner wires and SS wire to be assessed instead of other conventional procedures. Materials and Methods: Eight patients of Neer type II closed distal-third clavicle fracture of <3 weeks of duration were included in our study. The fractures were reduced by open reduction and fixed with TBW with two K-wires and SS wire. Results: The mean average age of patients was 41.87 years. All fractures united clinically and radiologically. The mean average time of union was 12 weeks. There was two case of hardware prominence, no fracture related complications. One case of superficial infection was found in study. All of them regained near normal range of motion, and the mean average constant Murley score for distal clavicle fracture at the end of 1 year was 88. At the end of 1 year follow-up, all patients had reached their pre-injury performance levels. Conclusion: There was an encouraging result with TBW in distal third clavicle fracture in our study. This technique is simple with lesser need of expertise and is also cost effective.

Guidelines for the use and reuse of animals for teaching within veterinary medical education programs

Use and reuse of animals for educational purposes could adversely affect animal welfare. Guidelines for quantifying, monitoring, and planning the use and reuse of animals have been developed. Within this framework, animals are assigned points for usage, with more points being allocated to procedures that may have a greater adverse effect on animal welfare. Usage of individual animals is limited to a maximum of 8 points in a calendar week, 24 points in a month, or 60 points within a 16-week study period and any associated examination period. Advantages and disadvantages of the system are discussed, while modifications are expected as knowledge emerges on the impacts of procedures on animal welfare.

Homeopathy for Major Depressive Disorder: Protocol for N-of-1 Studies

Background: N-of-1 studies allow the formal assessment of a patient’s treatment. A single participant receives different interventions the same number of times in a crossover, double-blind, randomized design. Using this methodology, we will investigate the effectiveness and safety of a standardized homeopathy protocol in treating 10 cases of major depression. Methods: The method is described below: Design: crossover double-blind placebo-controlled randomized N-of-1 studies, with at most 28 weeks of duration per participant. Participants: women and men at age over 18 years with a diagnosis of a major depressive episode given by a psychiatrist, who have presented a therapeutic response, i.e., a reduction ≥50% of the baseline depressive symptoms, self-assessed by the Beck Depression Inventory – Second Edition (BDI-II), and sustained for at least 4 weeks during an open homeopathic treatment following the protocol of the sixth edition of the Organon, with or without concomitant use of psychotropic drugs. Interventions: individualized homeopathy following the same protocol, one globule of the fifty-millesimal potency diluted in 20 mL of 30% alcohol; placebo – 20 mL of 30% alcohol, in the same posology as homeopathy. Crossover study: the participant will go through three consecutive treatment blocks, with two random and masked treatment periods (A or B), corresponding to homeopathy or placebo. Treatment periods will have 2, 4, and 8 weeks in the first, second, and third blocks, respectively. A clinically significant worsening (characterized by an augmentation in BDI-II inclusion score ≥30%) will result in the termination of study participation and resumption of the open treatment. Primary measure: progression of the depressive symptoms, self-assessed by the participant using the BDI-II scale at weeks 0, 2, 4, 8, 12, 16, 20, 24, 28 and analyzed throughout the study concerning homeopathy and placebo partitions. Secondary measures: score of the Clinical Global Impression Scale; mental and physical health scores assessed by the 12-Item Short-Form Health Survey; participant’s blind preference for treatment A or B at each block; clinical worsening; and adverse events. Data analysis: the participant, assistant physician, evaluator, and statistician will remain blinded for the study treatments until the completion of data analysis of each study. We will follow a 10-step procedure for analyzing N-of-1 observational data of each participant and conduct a meta-analysis of the combined results. Discussion: We understand that each N-de-1 study will be a chapter with its teachings in a book of ten, allowing a broader view of the effectiveness of the homeopathy protocol of the sixth edition of the Organon in treating depression.

40 Home-Based Virtual Rehabilitation Does Not Improve Daily Walking in the First Twelve Weeks After Discharge

Abstract Introduction Restoring cardiovascular fitness can be challenging during the first months after hospital discharge for adult burn patients. Furthermore, adherence to prescribed home therapy among people with burn injury has traditionally been low. We conducted a 5-year randomized controlled trial of 12-weeks of gamified virtual home therapy compared to prescribed home exercise (usual care). We hypothesized that those assigned to the virtual therapy would log more total daily walking during the intervention period. Methods All English-speaking adult patients hospitalized with burn injury were screened for participation. Eligibility criteria required discharge to home, personal smartphone, and access to a television with HDMI connectivity. Participants randomized to the virtual therapy group received access to a customized exercise software program with motion sensing hardware to use for twelve weeks in addition to usual home therapy instructions. All participants were instructed to continuously wear a provided actigraphy device during the 12-week period. Wilcoxon rank sum tests were used to compare median miles walked per day between groups. Adherence to the actigraphy device was defined a priori as having wear-data for 5 days in a calendar week. Results Actigraphy data from 44 participants (22 control, 22 experimental) were compared. Median miles walked per day increased from 1.5 miles/day (IQR 1.0-2.7) in Week 1 to 2.85 miles/day (IQR 1.8-4.5) in Week 12. Wilcoxon rank sum testing revealed no significant difference in median miles/day between groups during any week (Figure 1). Adherence to wearing the actigraphy device was equal or higher in control participants for all weeks. Conclusions Home-based virtual rehabilitation did not increase total daily walking during the first twelve weeks after discharge. At Week 12, daily walking is nearly twice that of Week 1 in both groups. Applicability of Research to Practice Post-discharge actigraphy data from people with burn injury can inform both patients and providers about activity after hospital discharge.

AN ASSESSMENT OF A LETHAL OVIPOSITION TRAP’S ABILITY TO PRODUCE IMMATURES OF AEDES ALBOPICTUS IN PANAMA CITY BEACH, FLORIDA

A series of tests were performed in the laboratory and in the field, 2014-2017, assessing the efficacy of the Trap ‘N’ Kill (TNK) (Springstar® Inc., Woodinville, WA) lethal ovitrap on Aedes albopictus adults and immatures. The TNK lethal ovitrap design is to attract and kill adult female mosquitoes as well as any larvae that emerge over a claimed 45-day period by utilizing the active ingredient dichlorvos. Cage trials demonstrate that the trap effectively killed wild-caught, adult mosquitoes (> 80% mortality) for up to 4 weeks (28 days). After 4 weeks, the ability of the trap to control adult mosquitoes declined reaching only 18.8 % mortality by week 7. A field trial demonstrated a similar 4-week maximum effective duration of the TNK trap when immature mosquitoes had emerged from eggs and were present in all traps after 4 weeks (6 weeks, 15.2 ± 2.56 % larvae per trap were observed). A field trial was also conducted to assess the ability of the TNK trap to reduce adult mosquito populations over a ~5-acre area in a residential neighborhood. No reduction in adult mosquito population could be detected with the trap density (5 traps/acre) and experimental conditions utilized in this trial.

Characterizing left ventricular diastolic function, exercise capacity and the adrenal cortex after yoyo diet-induced weight-cycling in mice with or without ovariectomy-induced post-menopausal condition

Studies report that only ∼20% of overweight people achieve sustainable weight loss with the risk to incur weight cycling. The over-shoot theory relates to an increased risk to develop metabolic syndrome (metS) and associated cardiovascular dysfunctions with successive phases of weight gain. In women, the prevalence of metS and heart failure with preserved ejection fraction (HFpEF) increases after menopause. To characterize the cardiac and adrenal consequences of yoyo-dieting in female mice with or without ovariectomy-induced post-menopausal condition. After ovariectomy (OVX) or not, mice were subjected to 3 cycles of a 60% high fat diet (HFD, 4-week duration) followed by a standard diet (SD) (increasing duration of 4, 6 and 10 weeks). Non-OVX control mice (CTL) were fed a SD. To assess the development of HFpEF, left ventricular (LV) function was characterized by ultrasound and invasive hemodynamics. Exercise capacity was evaluated on a treadmill. The morphology of the adrenal gland was described using HES staining, Sirius Red and immunofluorescence. Adrenal function and the vascular network were assessed using RT-qPCR to quantify mRNA expression for genes involved respectively in steroidogenesis and angiogenesis. At the end of the protocol, Yoyo mice had incomplete weight recovery and an insulin tolerance test indicated decreased sensitivity to the hormone. Moreover, there was an increase in LV-end-diastolic-pressure-volume-relation in OVX-Yoyo mice compared to CTL mice, indicating decreased compliance. In addition, the absence of difference in systolic fractional shortening (i.e., ejection fraction) and a lower exercise capacity in OVX-Yoyo mice compared to CTL demonstrated HFpEF. These OVX-Yoyo mice had major disorganization and remodeling in the adrenal gland with the apparition of dysplasia and fibrosis throughout the cortex. The vascular architecture was also affected, with lower expression of Vegf-a. Despite higher adrenal weight, there was no difference in cell proliferation. Whereas CYP11B2 expression, coding for the aldosterone synthase was not affected, the mRNA expression of CYP11B1, involved in glucocorticoids biosynthesis, was lower in OVX-Yoyo mice. Female mice in post-menopausal condition and subjected to yoyo-dieting showed an increased risk of developing HFpEF as well as major morphological and functional differences in the adrenal cortex.

Factors Affecting Self-Harm- or Violence-Related Urgent Psychiatric Consultation During the COVID-19 Pandemic in Taiwan.

People's health-care-seeking behaviors considerably changed during the COVID-19 pandemic. This study evaluated the changes in self-harm- and violence-related urgent psychiatric consultation (UPC) in the emergency department (ED) during different stages of the pandemic and at different levels of hospitals. We recruited patients who received UPC during the baseline (2019), peak (2020), and slack (2021) periods of the same time window (calendar weeks 4-18) during the COVID-19 pandemic. Demographic data such as age, sex, and referral type (by the police/emergency medical system) were also recorded. We found female gender and younger age associated with higher risk of self-harm-related UPCs, whereas patients visiting regional hospitals, male patients, and patients referred by the policy/emergency medical system, had a higher risk of violence-related UPCs. After adjustment, the different pandemic stages were not significantly associated with self-harm- or violence-related UPCs. Patient's demographic data, but not the pandemic itself, may be responsible for the changes in self-harm- and violence-related UPCs during the pandemic.

Vaccine effectiveness against transmission of alpha, delta and omicron SARS-COV-2-infection, Belgian contact tracing, 2021-2022.

Vaccine effectiveness against transmission (VET) of SARS-CoV-2-infection can be estimated from secondary attack rates observed during contact tracing. We estimated VET, the vaccine-effect on infectiousness of the index case and susceptibility of the high-risk exposure contact (HREC). We fitted RT-PCR-test results from HREC to immunity status (vaccine schedule, prior infection, time since last immunity-conferring event), age, sex, calendar week of sampling, household, background positivity rate and dominant VOC using a multilevel Bayesian regression-model. We included Belgian data collected between January 2021 and January 2022. For primary BNT162b2-vaccination we estimated initial VET at 96% (95%CI 95-97) against Alpha, 87% (95%CI 84-88) against Delta and 31% (95%CI 25-37) against Omicron. Initial VET of booster-vaccination (mRNA primary and booster-vaccination) was 87% (95%CI 86-89) against Delta and 68% (95%CI 65-70) against Omicron. The VET-estimate against Delta and Omicron decreased to 71% (95%CI 64-78) and 55% (95%CI 46-62) respectively, 150-200days after booster-vaccination. Hybrid immunity, defined as vaccination and documented prior infection, was associated with durable and higher or comparable (by number of antigen exposures) protection against transmission. While we observed VOC-specific immune-escape, especially by Omicron, and waning over time since immunization, vaccination remained associated with a reduced risk of SARS-CoV-2-transmission.

Physical (In)Activity Gender Gap of Slovak Non-athlete Adolescents

Study purpose. Declining levels of physical activity in adolescence are of increasing concern, with data showing the difference of ≥ 8% by gender in favor of adolescent boys; therefore, the present study aims at determining physical (in)activity gender gap of non-athlete adolescent boys and girls in Slovakia. Materials and methods. Standardized measure to estimate the habitual practice of physical activity (IPAQ-SF) was carried out six months (January – June, 2022), through the intentional sampling of 1 517 Slovak non-athlete adolescent boys (40.54%, n = 615) and girls (59.46%, n = 902), aged 18 – 19 years (18.50 ± 0.50 years), attending the secondary schools. Descriptive statistics (e.g., measures of frequency, central tendency), two-sample t-test and chi-square test (x2) were used to analyze and compare the data. Results. When considering the physical activity (seven-day week) in adolescence, the Slovak non-athlete adolescent boys and girls reported: (i) high levels of physical activity – 51.73% (n = 785); (ii) moderate levels of physical activity – 25.92% (n = 393); (iii) low levels of physical activity – 22.35% (n = 339) (p ˂ 0.01). When considering the gender gap in physical activity in adolescence, total physical activity (seven-day week), expressed in MET-minutes/ week, was lower (statistically, p ˂ 0.01; difference of 712 MET-minutes/ week) among the Slovak non-athlete adolescent girls (1 898 MET-minutes/ week), compared to boys (2 610 MET-minutes/ week). And when considering the gender gap and sitting time (sedentary behavior), the Slovak non-athlete adolescent girls were more sedentary, compared to boys (p ˃ 0.05) (360 vs. 330 minutes/ week). Conclusions. Constant low levels of physical activity in adolescence constitute the public health emergency of international concern; therefore, the urgent policy action to increase the physical activity is necessary; in particular, in promoting and retaining the adolescent girls’ participation in physical activity.

Vaccine Effectiveness Against Severe Acute Respiratory Syndrome Coronavirus 2 Delta and Omicron Infection and Infectiousness Within Households in the Netherlands Between July 2021 and August 2022.

We aimed to estimate vaccine effectiveness against infection (VE-infection) and against further transmission (VE-infectiousness) in a household setting during Delta and Omicron. Knowing these effects can aid policy makers in deciding which groups to prioritize for vaccination. Participants with a positive severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) test were asked about coronavirus disease 2019 (COVID-19) vaccination status and SARS-CoV-2 testing of their household members 1 month later. VE-infection and VE-infectiousness were estimated using generalized estimating equation logistic regression adjusting for age, vaccination status, calendar week, and household size. A total of 3399 questionnaires concerning 4105 household members were included. During the Delta period, VE-infection and VE-infectiousness of primary series were 47% (95% confidence interval [CI], -27% to 78%) and 70% (95% CI, 28% to 87%), respectively. During the Omicron period, VE-infection was -36% (95% CI, -88% to 1%) for primary series and -28% (95% CI, -77% to 7%) for booster vaccination. VE-infectiousness was 45% (95% CI, -14% to 74%) for primary series and 64% (95% CI, 31% to 82%) for booster vaccination. Our study shows that COVID-19 vaccination is effective against infection with SARS-CoV-2 Delta and against infectiousness of SARS-CoV-2 Delta and Omicron. Estimation of VE against infection with SARS-CoV-2 Omicron was limited by several factors. Our results support booster vaccination for those in close contact with vulnerable people to prevent transmission.

TABLE EGG QUALITY AND NUTRITIONAL COMPOSITION ASSESSEMENTS OF DIFFERENT BREEDS AND AGES OF LAYING HENS

Table eggs collected at random from one-hundred and fifty layers (75-FUNAAB-Alpha and 75- ISA brown) kept at Breeding Unit, Teaching and Research Farm, Olusegun Agagu University of Science and Technology, Okitipupa at 31st, 33rd, and 35th weeks (WK) of age were analyzed for internal and external characteristics within 24 hours of laying. The data collected were subjected to analysis of variance to assess the effect of breed and age of the layers on egg quality. Breed had no significant effect (p > 0.05) on the egg weight (Ewt), egg length (EL), shell weight (SW), shell ratio (SR), albumen weight (AW), albumen ratio (AR), yolk diameter (YD) and yolk height (YH) in all the ages considered. At WK 31 breed effect was observed (p < 0.05) in egg width (EW), shell index (SI), yolk weight (YW), yolk ratio (YR), albumen height (AH) and haugh unit (HU), and higher values were observed in all the traits for ISA brown except yolk weight (YW) and yolk ratio (YR). Significant effect of breed (< 0.05) was observed in HU and AH at WK33. Shell thickness (ST) and yolk index (YI) experienced breed effect at WK 35. Breed and age had no effect on nutritional compositions of eggs. It can be concluded that breed and layer's age do have effects on some egg quality parameters.

Critical care pharmacy workforce: a 2020 re-evaluation of the UK deployment and characteristics

IntroductionCritical care pharmacists improve the quality and efficiency of medication therapy whilst reducing treatment costs where they are available. UK critical care pharmacist deployment was described in 2015, highlighting a deficit in numbers, experience level, and critical care access to pharmacy services over the 7-day week. Since then, national workforce standards have been emphasised, quality indicators published, and service commissioning documents produced, reinforced by care quality assessments. Whether these initiatives have resulted in further development of the UK critical care pharmacy workforce is unknown. This evaluation provides a 2020 status update.MethodsThe 2015 electronic data entry tool was updated and circulated for completion by UK critical care pharmacists. The tool captured workforce data disposition as it was just prior to the COVID-19 pandemic, at critical care unit level.Main findingsData were received for 334 critical care units from 203 organisations (96% of UK critical care units). Overall, 98.2% of UK critical care units had specific clinical pharmacist time dedicated to the unit. The median weekday pharmacist input to each level 3 equivalent bed was 0.066 (0.043–0.088) whole time equivalents, a significant increase from the median position in 2015 (+ 0.021, p < 0.0001). Despite this progress, pharmacist availability remains below national minimum standards (0.1/level 3 equivalent bed). Most units (71.9%) had access to prescribing pharmacists. Geographical variation in pharmacist staffing levels were evident, and weekend services remain extremely limited.ConclusionsAvailability of clinical pharmacists in UK adult critical care units is improving. However, national standards are not routinely met despite widely publicised quality indicators, commissioning specifications, and assessments. Additional measures are needed to address persistent deficits and realise gains in organisational and patient-level outcomes. These measures must include promotion of cross-professional collaborative working, adjusted funding models, and a nationally recognised training pathway for critical care pharmacists.

In-Depth Analysis of the Re-Emergence of Respiratory Syncytial Virus at a Tertiary Care Hospital in Germany in the Summer of 2021 after the Alleviation of Non-Pharmaceutical Interventions Due to the SARS-CoV-2 Pandemic.

Following the extensive non-pharmaceutical interventions (NPIs) and behavioral changes in the wake of the SARS-CoV-2 pandemic, an interseasonal rise in respiratory syncytial virus (RSV) cases was observed in Germany in 2021. The aim of this study was to characterize the local molecular epidemiology of RSV infections in comparison to the three pre-pandemic seasons. Additionally, clinical data were retrieved from patient charts to determine the clinical significance of RSV infections. RSV detections peaked in calendar week 40 of 2021, 18 weeks earlier than the usual peak observed in the three pre-pandemic seasons. Sequence analysis revealed a close phylogenetic relatedness regardless of the season of origin. A significantly higher amount of pediatric cases (88.9% of all cases, p < 0.001) was observed for season 2021/2022. For the pediatric cases, significant differences were observed for an increased number of siblings in the household (p = 0.004), a lower rate of fever (p = 0.007), and a reduced amount of co-infections (p = 0.001). Although the mean age of the adult patients was significantly younger (47.1 vs. 64.7, p < 0.001), high rates of comorbidities, lower respiratory tract infections and intensive care unit admissions prevailed. The NPIs in the wake of the SARS-CoV-2 pandemic had a tremendous impact on the epidemiologic characteristics and seasonality of RSV and warrant further epidemiologic studies of this important pathogen.